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Update on the Epidemiology, Diagnosis, and Treatment of Mania in Older-Age Bipolar Disorder

  • Geriatric Disorders (W McDonald, Section Editor)
  • Published:
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Abstract

Purpose of Review

The population over age 60 is growing more rapidly than the general population. Given the projected increase and need for data that can inform treatment, this review provides a brief description of newer publications focused on mania in older-age bipolar disorder (OABD), including epidemiology, diagnosis, and treatments.

Recent Findings

Age cutoffs to define OABD range from 50 to 65 years. OABD clinical presentation and course of illness is highly variable, often characterized by mood episode recurrence, medical comorbidity, cognitive deficits, and impaired functioning. There is little pharmacotherapy data on mania in OABD. Lithium and valproate have been tested in a single randomized controlled trial and there is data of more limited quality with other compounds.

Summary

Treating OABD is challenging due to medical complexity, comorbidity, diminished tolerance to treatment, and a limited evidence base. More data is needed to keep pace with clinical demand.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Department of Psychiatry, Case Western Reserve University School of Medicine, Louis Stokes Veterans Administration Medical Center, Cleveland, OH, USA

    Peijun Chen

  2. Department of Old Age Psychiatry, GGZ inGeest, VU University Medical Center, Amsterdam, The Netherlands

    Annemiek Dols

  3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Soham Rej

  4. Jewish General Hospital/Lady Davis Institute, McGill University, Montreal, QC, Canada

    Soham Rej

  5. Departments of Psychiatry and of Neurology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, 10524 Euclid Avenue, Cleveland, OH, 44106, USA

    Martha Sajatovic

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  1. Peijun Chen
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  2. Annemiek Dols
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  3. Soham Rej
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  4. Martha Sajatovic
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Correspondence to Martha Sajatovic.

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Peijun Chen, Annemiek Dols, and Soham Rej each declare no potential conflicts of interest.

Martha Sajatovic has received grant support from Alkermes, Janssen, Pfizer, and Merck and royalties from Springer Press, Johns Hopkins University Press, and Oxford Press and served as consultant for Bracket, Pfizer, Otsuka, Sunovion, Neurocrine, Supernus, and Health Analytics.

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Chen, P., Dols, A., Rej, S. et al. Update on the Epidemiology, Diagnosis, and Treatment of Mania in Older-Age Bipolar Disorder. Curr Psychiatry Rep 19, 46 (2017). https://doi.org/10.1007/s11920-017-0804-8

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